Connected health technology may be opening the door to the detection and prevention of one of the leading causes of stroke.
Atrial fibrillation (AF), the most common abnormal heart rhythm, is responsible for one third of all strokes. It’s present in roughly one quarter of all adults over the age of 40, making them five times more susceptible to having a stroke. Typically, it’s only detected after someone has a stroke – when doctors are able to sit a patient down for a 30-to-60-day stretch and regularly monitor one’s heartbeat.
While AF is very difficult to detect during a normal visit to the doctor’s office, physicians who have access to ECGs on a daily basis stand a much better chance of spotting the condition and treating it before it causes a stroke.
That’s where mHealth comes into play. While bulky, uncomfortable Holter monitors or a visit to the hospital are still considered the standard procedure for checking for AF, wearable monitors and patches – and even the Apple Watch – are rapidly gaining ground. Among their benefits, they allow providers to track patients during the normal course of a day or week, while they’re going through normal, every-day routines, when instances of AF most often occur and are undetected.
"If more patients with atrial fibrillation can be detected, then more patients can receive appropriate stroke prevention therapy, and the hope is that more strokes, deaths, disability and dementia can be avoided," David Gladstone, a professor at the University of Toronto, told the New York Times in 2014. Gladstone was the lead researcher in a study that found that AF was diagnosed in five times as many patients who were monitored regularly for 30 days, as opposed to the 24-hour time window used in in-patient sessions.
In fact, studies using wearable monitors helped convince the American Medical Association in 2014 to change its guidelines to indicate that it’s “reasonable” to expect healthcare providers to monitor for AF over a 30-day period, rather than 24 hours.
The trick, of course, is to get consumers interested in wearing monitors for a month.
AliveCor, a San Francisco-based developer of mHealth platforms for cardiac care and one of the best known in the field, recently unveiled a sensor-embedded watchband in an effort to link medical-grade ECG technology with the consumer wearable market. The FDA-approved Kardia Band, expected to go on the market later this year, attaches to the Apple Watch and is used to monitor one’s heart rate for the presence of AF.
While users can tap the sensor to get an up-to-date ECG reading, the band and an accompanying Kardia app store that information and send it directly to healthcare providers. The user can also record voice notes on the watch to accompany the readings, giving providers more information on what might have caused a higher-than-normal or irregular reading.
AliveCor isn’t the only player in the market. InfoBionic, a Massachusetts-based digital health startup, recently secured FDA 510(k) clearance for MoMe Kardia, a wireless device that acquires and stores ECG and motion data and sends it to a cloud-based MoMe Software System platform, where the data is analyzed for AF.
“MoMe Kardia is a 3-in-1 device that seamlessly transitions between Holter, Event and MCT modes remotely, streamlining patient monitoring time without delays,” Nancy Briefs, the company’s co-founder and CEO, said in announcing the FDA clearance. “In addition, MoMe Kardia leverages a comprehensive cloud-based proprietary platform … to deliver on-demand, actionable data and analytics directly to the physicians. The sleek, lightweight form factor of MoMe Kardia is designed so patients can wear it discretely and manage only one device during monitoring. MoMe Kardia empowers physicians to transform the efficiency with which they manage cardiac arrhythmia detection and monitoring processes for their patients.”
Most consumer-facing wearables currently rely on LED sensors to track a user’s heart rate, a method that’s been questioned for its reliability. That won’t pique the interest of most healthcare providers. But as wearables – be they wrist-borne monitors, patches, sensors, even smartglasses – become more sophisticated, expect doctors to take notice.